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Sepsis: Battling a Leading Cause of Death in Hospitalized Children

September is Sepsis Awareness Month. In a recent issue of Children’s Hospitals Today, Megan McDonnell Busenbark discusses sepsis and the steps being taken to recognize, and treat, pediatric sepsis.

Sepsis is highly elusive in its early stages. To combat it, hospitals must adopt tools, team-based approaches and change culture.

By Megan McDonnell Busenbark

Rory Staunton was 12 years old when he went diving for a basketball in his school gym and scraped his arm—business as usual for a boy his age. But the next day, Rory was vomiting and feverish. He had pain in his leg. A visit to the pediatrician led to a trip to a New York City hospital emergency room. Doctors there believed Rory had an upset stomach and dehydration, so they gave him fluids and sent him home.

What doctors failed to see was that a deadly toxin had entered Rory's blood through the seemingly innocent cut on his arm. Warning signs of severe illness went unnoticed. Three nights after he left that emergency room, 12-year-old Rory was dead. The cause: severe septic shock brought on by infection.

That was in April 2012. The following January, Gov. Andrew M. Cuomo announced "Rory's Regulations," making New York the first state to require all hospitals to adopt best practices for the early identification and treatment of sepsis—a leading cause of death in hospitalized children.

Sepsis, often called blood poisoning, is the body's overwhelming and potentially deadly response to an infection. It affects more than 1 million people in the United States each year, according to the Centers for Disease Control and Prevention. This includes more than 40,000 children, 4,500 of whom die each year from the disease and related complications—a higher mortality than pediatric cancer.

"Children don't need to die of sepsis," says Joseph A. Carcillo, M.D., professor of critical care medicine and pediatrics at the University of Pittsburgh. "But it's a very complex process because organizationally, there are so many people involved in the care of these children. And culturally, we've come to accept death from sepsis."